Orthosis and corrective joint

ABSTRACT

An orthesis for stabilizing a joint has a joint rail having a first and a second rail portion which can be pivoted relative to each other about a joint axle. The orthesis has a pressure member which can be adjusted by a relative pivoting of the two rail portions about the joint axle in the direction towards and counter to the joint to be stabilized. One of the two rail portions has a cam disc, and the other of the two rail portions has a rotor which is guided on the cam disc, wherein the cam disc or the rotor is axially fixed in position on the correction pad.

CROSS-REFERENCE TO RELATED APPLICATIONS

This continuation application claims priority to PCT/EP2013/071005 filedon Oct. 9, 2013 which has published as WO 2014/060251 A1 and also theGerman application number 10 2012 218 804.5 filed on Oct. 16, 2012, thecontents of which are fully incorporated herein with these references.

FIELD OF THE INVENTION

The present invention relates to an orthesis for stabilizing, guidingand/or correcting a joint.

BACKGROUND OF THE INVENTION

Ortheses have been used for some time as an auxiliary medical means forfunctionally stabilizing, relieving, guiding and/or correcting joints.For instance, knee ortheses are used, for example, after treatingruptures of the anterior or posterior cruciate ligament, aftercollateral ligament lesions and in the case of meniscus and cartilagedamage.

The ortheses generally have a pair of joint rails each having a firstand a second rail portion which are connected to each other in anarticulated manner via an orthesis joint at the ends thereof facing eachother. The two rail portions can be pivoted relative to each other abouta joint axle and can be fixed via fixing means, for example, belts orhook and loop bands, to a respective limb portion, for instance, theupper leg and lower leg.

Although the ortheses are either available in different sizes or arealso individually adapted, the joint to be treated with the orthesisoften cannot be stabilized or relieved or actively corrected to thedesired extent. This may be the case in particular with post-operativeor post-traumatic swellings in the joint region and in the event ofvalgus or varus malalignments of the joint to be treated. In the case ofvalgus malalignment, the distal limb portion, that is to say, forexample, the lower leg, becomes displaced outwards away from the centeraxis of the limb beyond the normal dimension, whereas the term varusmalalignment is intended to be understood to be a displacement inwards.The inadequate stabilization, guiding, relieving or active correction ofthe joint to be treated or the ligamentous apparatus near the joint canresult in a protracted recovery period and where applicable a permanentjoint instability.

On the basis of the above-mentioned prior art, an object of theinvention is to provide an orthesis and a correction joint for anorthesis which allows improved lateral joint stabilization, guiding,relieving and/or active correction.

The object relating to the orthesis is achieved by an orthesis havingthe features set out in the first independent patent claim. Thecorrection joint according to the invention for the orthesis has thefeatures set out in a dependent patent claim. The dependent claimsrelate to advantageous developments of the invention.

SUMMARY OF THE INVENTION

In the orthesis according to the invention, a defined valgus or varusmoment can be applied to the joint in accordance with a respective pivotposition of the two rail portions relative to each other, that is tosay, in accordance with a flexion of the joint treated with theorthesis, as a result of the correction pad (=pressure member) which isarranged for translational movement along the joint axle. Thus, thecorrection pad can be guided in the direction towards and counter to thejoint to be treated, for example, in a neutral position (0° of the jointaccording to the so-called neutral zero method, the standardizedorthopedic evaluation index for joints) or in a bending position(flexion) of the joint, for example, for a knee angle range from 0 to25° or approximately 30°. In the case of a knee joint, the correctionpad can be guided and pressed, for example, against the condylusmedialis femoris, that is to say, the distal joint extension of theupper leg bone directed towards the center of the body (valgusmoment-correction in the varus sense). The joint to be treated with theorthesis can thereby be generally laterally stabilized, relieved, guidedand/or actively corrected in a more effective manner. Furthermore,secondary damage to the joint or to the ligamentous apparatussurrounding the joint can thereby be effectively prevented. Theindividual recovery period and recovery success can thereby be improvedreadily and in an economic manner. The correction pad may in particularbe a portion of a correction joint of the orthesis, via which portionthe two rail portions of the joint rails are connected to each other inan articulated manner.

The axial movement of the correction pad along the joint axle is derivedaccording to the invention from the pivoting movement of the two railportions in that one of the two rail portions has a cam disc which isconnected to that rail portion in a rotationally secure manner and theother of the two rail portions has a rotor (=control member) whichadjoins the cam disc. The rotor is rigidly fixed/supported on the otherrail portion preferably in an axial direction. The cam disc or the rotoris axially fixed in position on the correction pad so that thecorrection pad is moved in translation along the joint axle in the eventof pivoting of the two rail portions and the resultant relative movementof the cam disc and the rotor which adjoins the cam disc. That is tosay, the correction pad carries out a forward travel movement which isorientated along the joint axle of the orthesis in the direction towardsand counter to the joint which has been axially malaligned (=valgus orvarus malalignments) and which is treated with an orthesis. Therelationship between a respective change of an angle which is enclosedby the two rail portions and an axial adjustment movement of thecorrection pad, which movement is derived therefrom, can readily beadjusted (predetermined) on the basis of a flank pitch of the cam withrespect to the joint axle. Furthermore, a (total) travel of thecorrection pad in an axial direction can be predetermined on the basisof the cam height. The term “cam height” is intended to be understood tobe the spacing of the cam tip of the cam from the (axial) nominal heightof the cam disc which corresponds to the rest position of the correctionpad.

The backward movement of the correction pad from the (active) forwardtravel end position into the axial rest position thereof can be carriedout in a purely passive manner according to the invention. It will beunderstood that the correction pad may also be able to be moved backalternatively by means of a restoring spring or the like from theforward travel end position into the rest position.

According to the invention, the cam disc may in particular be formed bya cam ring. The cam ring is fixed to the correction pad preferably in areleasable manner. On the one hand, this affords technical advantages interms of production. On the other hand, the cam ring can readily bechanged or, where applicable, also removed without any replacement inthe case of wear or also in the case of changing medical requirements.It will be understood that the cam disc may also be formed by a camplate.

The cam ring may be adjustable in particular in a variably steplessmanner on the correction pad in terms of the axial position thereof andin terms of the rotational position thereof on the correction pad. As aresult of the selection of the cam profile height, the forward travelend position of the correction pad can be (finely) adjusted and adaptedto the individually necessary dimension and in accordance with arespective relative pivot position of the two rail portions in relationto each other in accordance with requirements. Furthermore, the controltimes can be adjusted by rotating the cam ring. This may be advantageousin particular in the case of a swollen knee or elbow joint. Thus, thecorrection pad may be pressed counter to the knee joint or the elbowjoint, for example, (only) between a bending position of from 20 degreesto the neutral position of the joint to be stabilized. Furthermore, adesired pressing pressure of the correction pad counter to the joint tobe stabilized (=valgus or varus moment) can thereby be readily adjusted.In particular, the correction of the orthesis joint may be dispensedwith where applicable in the case of the bending, for example, for aknee angle greater than 80° so that lateral relieving of the knee jointis produced whilst sitting.

An excessive loading of the joint which is intended to be stabilizedwith the orthesis can be prevented according to the invention in thatthe correcting orthesis allows only a limited movement extent in thejoint. This can be achieved in the structurally simplest case in thatthe cam ring has one or more stops for the rotor.

From structural viewpoints, the orthesis preferably has an annular(rotary) joint.

The correction pad can be arranged in an axially displaceable manner inparticular on a bearing member which is engaged round by the (rotary)joint. This allows a coaxial adjustment of the correction pad inrelation to the joint axle. In this instance, the bearing member ispreferably connected in a rotationally secure manner to one of the tworail portions of the joint rail.

According to a particularly preferred development of the invention, thecorrection pad has at least one bearing journal which extends through ahole of the bearing member and via which the correction pad is supported(in a sliding manner) in the hole in an axial direction. The hole or thebearing journal may be provided with a PTFE (polytetrafluoroethylene)coating or a PTFE sliding sleeve. According to the invention, thecorrection pad may also have two or more such bearing journals.

The bearing journal may particularly be provided at one end with aretention portion, on which the cam ring is releasably fixed. Theretention portion may in particular be provided with a retention collarfor the cam member. It is thereby readily possible to prevent thecorrection pad from being removed axially or falling out of the hole ofthe bearing member. In this embodiment, consequently, the retentionportion may form a stop for an axial forward travel movement of thecorrection pad.

The rotor may have according to the invention a ball-bearing roller. Itis thereby possible to achieve a particularly robust function of theorthesis with respect to malfunctions. Furthermore, adjustment noiseswhich are disruptive in practice can be reliably prevented.

The correction pad is preferably provided with a padded coating. This isadvantageous for wearing comfort and patient safety. Furthermore,pressure points can thereby be combated in a reliable manner.

The wearing comfort and patient safety can be improved even further inthat the padded coating on the correction pad is arranged so as to befreely rotatable. This can be brought about according to the invention,for example, by means of a rotary plate or the like which is rotatablysupported on the correction pad.

It will be understood that the rail portions may each have fixing meansfor limb portions, for example, tension belts. For reasons of comfort,the fixing means are preferably provided with hook and loop closures.

The orthesis may advantageously be produced from a light metal, inparticular aluminum or an aluminum alloy, or from a carbon fibermaterial or an unbreakable plastics material. The rail portions may beformed substantially from a formed and bent wire profile.

According to a development of the invention, the orthesis has anotherjoint rail. The additional joint rail may be arranged in particular withspacing from the first joint rail and may also have two rail portions.The joint which is intended to be stabilized with the orthesis canthereby be supported, stabilized and/or corrected at both sides. Theadditional joint rail may also have according to the invention acorrection pad formed in the manner explained above. The correction padsof the two joint rails may be arranged so as to be axially adjustable inthe same direction or in opposite directions in particular synchronouslyor independently of each other.

A correction joint according to the invention for an above-explainedorthesis comprises the joint axle and the correction pad which isaxially adjustable along the joint axle. The correction joint preferablyhas two joint portions which can be pivoted relative to each other aboutthe joint axle. The two rail portions of the orthesis may be able to befixed to the two joint portions, preferably in a releasable manner.Consequently, the correction pad which is axially adjustable along thejoint axle is an integral component of the correction joint and can bedisplaced (in a restricted manner) along the joint axle by means of arelative pivoting of the two joint portions about the joint axle.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention is explained in greater detail below with reference to anembodiment which is illustrated in the drawings, in which:

FIG. 1 is a sectional cut-out of an orthesis having a joint rail whichhas two rail portions which can be pivoted relative to each other, andhaving a correction pad which is axially adjustable by pivoting the railportions about the joint axle;

FIG. 2 is a sectional cut-out of the orthesis from FIG. 1 with acorrection pad arranged in a forward travel end position;

FIG. 3 is a side view of a cut-out of the orthesis from FIG. 1; and

FIG. 4 is a perspective cut-out of a cam ring of the orthesis accordingto FIG. 1, by means of which cam ring the pressure member is coupled interms of movement to the two rail portions of the joint rail.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIG. 1 is a longitudinally sectioned cut-out of an orthesis 10 accordingto the invention. The orthesis 10 serves to stabilize a knee joint whichis not illustrated in greater detail and has a joint rail 12 having afirst and a second rail portion 14, 16. The two rail portions areconnected to each other by means of a correction joint 18 in the form ofa rotary joint at the mutually facing ends 14 a, 16 a thereof. Fixingmeans 20 are used to fix the orthesis to the upper leg or lower leg of aperson to be treated (not shown). The fixing means 20 are variablyadjustable in terms of the axial position thereof on the rail portions14, 16.

The correction joint 18 has a joint axle (axis) 18 a, about which thetwo rail portions 12, 14 can be pivoted relative to each other. There isarranged on the joint rail 12 a correction pad 22 which can be moved bya pivoting movement of the two rail portions 12, 14 in the rotary joint18 along the joint axle 20 in the direction towards and counter to theknee joint which is intended to be stabilized, as indicated by the arrow24. The pressure pad 22 has at one end a rotary plate 26 having a paddedcoating 28.

The correction pad 22 has two bearing journals 30 which are arrangedwith spacing from each other and which each have a cylindricalcross-section. The bearing journals 30 extend through holes 32 of aninner bearing member 34 which is engaged round at the peripheral side bythe rotary joint 18. The holes 32 of the inner bearing member 34 areeach provided with sliding sleeves 34′, on which the bearing journals 30of the correction pad 22 are guided in an axially displaceable mannerwith sliding play and positive-locking. The sliding sleeves 36 maycomprise in particular PTFE (polytetrafluoroethylene) or a PTFE-basedmaterial.

A disc-like retention member 36 is arranged at one end on the bearingjournals 30. A cam ring 38 is releasably fixed to the retention member36 by means of a plurality of screws 40. The cam ring 38 is arranged ina state held on the retention member 36 in a rotationally secure andaxially non-displaceable manner and can be arranged so as to besteplessly variable in terms of the rotary position thereof relative tothe joint axle 18 a and in terms of the axial position thereof on theretention member 36 by the screws 40 being loosened. As can be seen inFIG. 1, the cam ring 38 adjoins a collar 36 a of the retention member 36in this instance.

The cam ring 38 has a cam disc 38 a, that is to say, a control camhaving a cam (not shown) which is illustrated in greater detail in FIGS.3 and 4. In other words and as can be seen in FIG. 4, the cam ring 38has a changing/variable cam surface 38 a.

A rotor 42 adjoins the cam disc 38 a. The rotor 42 is arranged on abearing block 44 of the first rail portion 14 and is in the form of aball-bearing roller which can be freely rotated about a roller axis 46.

When the two rail portions 14, 16 are pivoted in the rotary joint 18,consequently, the rotor 42 rolls on the cam disc 38 a which is guidedunder the rotor 42. As soon as the rotor 42 is guided against the cam(not shown), the cam ring 38 is moved together with the correction pad22 out of the rest position 48 shown here along the joint axle 18 a ofthe rotary joint 18 in the direction 24 towards and counter to the kneeto be stabilized.

A forward travel end position of the correction pad 22 is designated 50.In this instance, the correction pad 22 has a travel 52 of approximately10 mm in this instance. The travel 52 corresponds to the axial spacingbetween the neutral position 48 and the forward travel end position 50of the correction pad 22.

FIG. 2 shows the orthesis 10 with the correction pad 22 adjusted into aforward travel end position 50. The two rail portions 14, 16 are notangled relative to each other in the embodiment shown here. The rotor 42adjoins the cam 38 b of the cam disc 38 a of the cam ring 38. The camhas, in relation to the nominal height N of the cam disc, a cam height Hwhich corresponds to the travel 52 of the correction pad 22. Thecorrection pad 22 adjoins, in the forward travel end position 50 shown,the knee joint which is intended to be stabilized with the orthesis,preferably in the region of the medial or lateral condyle.

FIG. 3 is a side view of a cut-out of the orthesis 10 with thecorrection pad removed. The cam ring 38 with the rotor 42 which ispositioned thereon at the front side can clearly be seen. The railportions 14, 16 are substantially constructed as profiled light metalstruts. The rail portions 14, 16 may also be formed from a differentmaterial, in particular from a carbon fiber material.

FIG. 4 is a perspective cut-out view of the cam ring 38. The cam disc 38a comprises the cam 38 b, by means of which the correction pad can beaxially adjusted. A stop 38 c for the rotor 42 serves to delimit themovement extent of the two rail portions 14, 16 in the rotary joint 18(FIG. 1).

The above-described orthesis is particularly suitable for all medicalindications in which it is necessary to guide, stabilize, relieve and/orcorrect the knee joint or elbow joint or to relieve the joint, such as,for example, in the case of a higher-grade and/or complex instability ofthe knee joint, in meniscus injuries, cartilage damage and forfunctional pre-operative and/or post-operative care, in particular afterruptures of the ligamentous apparatus with or without axialmalalignments. The orthesis has a correction joint which is in the formof a rotary joint and which has a first and a second rail portion whichcan be pivoted about a joint axle relative to each other. The correctionjoint has a correction pad which can be moved by means of an adjustmentmovement which is derived from the pivoting movement of the two railportions along the joint axle in the direction towards and counter tothe joint which is intended to be stabilized/corrected.

What is claimed is:
 1. An orthesis for stabilizing, guiding and/orrelieving a joint, the orthesis comprising: a joint rail having a firstand a second rail portion which can be pivoted relative to each otherabout a joint axle; a correction pad which can be adjusted by a relativepivoting of the two rail portions about the joint axle in a directiontowards and counter to the joint to be stabilized; wherein one of thetwo rail portions has a cam disc; wherein the other of the two railportions has a rotor which is guided on the cam disc; and wherein thecam disc or the rotor is axially fixed in position on the correctionpad.
 2. The orthesis according to claim 1, wherein the cam disc isformed by a cam ring which is fixed to the correction pad in areleasable manner.
 3. The orthesis according to claim 2, wherein the camring can be arranged on the correction pad so as to be variable in termsof the axial position thereof and in terms of the rotational positionthereof relative to the correction pad.
 4. The orthesis according toclaim 2, wherein the cam ring has one or more stops for the rotor. 5.The orthesis according to claim 1, wherein the joint rail has a bearingmember which is arranged on the joint axle and on which the correctionpad is supported in an axially displaceable manner.
 6. The orthesisaccording to claim 5, wherein the correction pad has one or more bearingjournal(s) which is/are slidingly supported in holes of the bearingmember.
 7. The orthesis according to claim 6, wherein the bearingjournal(s) are cylindrical.
 8. The orthesis according to claim 6,wherein the bearing journals are provided at one end with a retentionportion, on which the cam ring is releasably fixed.
 9. The orthesisaccording to claim 1, wherein the rotor has a ball-bearing roller. 10.The orthesis according to claim 1, wherein the correction pad has arotary plate having a padded coating.
 11. The orthesis according toclaim 1, including another joint rail having a first and a second railportion.
 12. An orthesis for stabilizing, guiding and/or relieving abodily joint of a person, the orthesis comprising: a first rail portionattachable to either an upper leg or a lower leg of the person; a secondrail portion attachable to the other of the upper leg or the lower legof the person; a mechanical joint pivotably coupling the first railportion to the second rail portion, where the first rail portion can bepivoted relative to the second rail portion about a joint axis that isgenerally aligned with the bodily joint of the person; a correction padtranslatably attached relative to the first rail portion through themechanical joint aligned along the joint axis, the correction paddisposed on an inside portion of the orthesis facing towards the bodilyjoint of the person; a cam ring attached to the correction pad, the camring disposed on an outside portion of the orthesis, where the cam ringis rotatably adjustable and securable relative to the first railportion, the cam ring having a variable surface; wherein the correctionpad and cam ring are translatable relative to the first and second railportions in a direction aligned with the joint axis; a rotor rotatablyattached to the second rail portion, wherein the rotor abuts and engagesthe variable surface of the cam ring; wherein a pivotable movement ofthe first rail portion in relation to the second rail portion creates atranslation movement of the correction pad along the joint axis due tothe rotor engaging the variable surface of the cam ring.
 13. An orthesisfor stabilizing, guiding and/or relieving a bodily joint of a person,the orthesis comprising: a first rail portion pivotably attached to asecond rail portion about a joint axis, either rail portion attachableto an upper leg or a lower leg of the person; a correction padtranslatably attached relative to the first rail portion aligned alongthe joint axis, the correction pad disposed on an inside portion of theorthesis facing towards the bodily joint of the person; a cam ringattached to the correction pad, the cam ring having a variable surface,where the correction pad and cam ring are translatable in a directionaligned with the joint axis; a rotor rotatably attached to the secondrail portion, wherein the rotor abuts and engages the variable surfaceof the cam ring; wherein a pivotable movement of the first rail portionin relation to the second rail portion creates a translation movement ofthe correction pad along the joint axis due to the rotor engaging thevariable surface of the cam ring.
 14. The orthesis according to claim13, wherein the cam ring is rotatably adjustable relative to the firstrail portion.
 15. The orthesis according to claim 13, including a camring retention member attached to the correction pad, wherein the camring is rotatably adjustable and securable in relation to the cam ringretention member.
 16. The orthesis according to claim 15, wherein thecam ring comprises at least one female-threaded fastener hole configuredto receive a fastener thereby securing the cam ring to the cam ringretention member.
 17. The orthesis according to claim 13, wherein thecam ring can be arranged in relation to the correction pad so as to bevariable in terms of the rotational position thereof relative to thecorrection pad.
 18. The orthesis according to claim 13, wherein therotor has a ball-bearing roller.
 19. The orthesis according to claim 13,wherein the correction pad has a rotary plate having a padded coating.20. The orthesis according to claim 13, wherein the cam ring comprisesone or more stops for the rotor preventing passage of the rotor beyondthe stop.